抗双链DNA抗体和抗核小体抗体定性检测对系统性红斑狼疮的诊断价值

目的:评价免疫印迹法抗双链DNA(ds-DNA)抗体、抗核小体抗体(ANuA)及绿蝇短膜虫间接免疫荧光法抗dsDNA抗体检测在系统性红斑狼疮(SLE)中的诊断价值。方法:分别运用免疫印迹法、绿蝇短膜虫间接免疫荧光法及ELISA法检测166例SLE疾病活动期(包括初发和复发)患者血清中抗ds-DNA抗体、ANuA的水平。以酶联免疫吸附法(ELISA)检测结果为标准,评价抗ds-DNA抗体和ANuA定性检测对SLE的诊断价值。结果:免疫印迹法检测抗ds-DNA抗体及ANuA诊断SLE的阳性符合率分别为73.33%、66.28%,绿蝇短膜虫间接免疫荧光法检测抗ds-DNA抗体诊断SLE的阳性符合率为68.57%;随着抗ds-DNA抗体和ANuA滴度的减小,其免疫印迹法或间接免疫荧光法检测阳性符合率均降低(P0.05)。结论:抗ds-DNA抗体、ANuA定性检测诊断SLE的阳性率均不理想,建议在ELISA检测抗ds-DNA抗体和ANuA诊断SLE的基础上采用。

Values of qualitative assays for anti-ds-DNA and anti-nucleosome antibodies in diagnosis of systemic lupus erythematosus

Objective To assess the value of anti-double stranded DNA(ds-DNA) antibody and anti-nucleosome antibody(ANuA) of western blot, and Crithidia luciliae based indirect immunofluorescence for ds-DNA antibody in systemic lupus erythematosus patients. Methods The levels of ds-DNA antibodies and ANuA were detected in 167 activity (including initial and recurrent) SLE patients through their serum samples by western blot and Crithidia luciliae based indirect immunofluorescence and ELISA ,and the diagnostic value of ds-DNA antibody and ANuA in SLE was evaluated from the aspects of statistical and clinical economics. Results The sensitivity and specificity of ds-DNA antibody of ANAs in diagnosis of SLE were 66.9% and 91.3%, respectively. The sensitivity of ANuA was 55.8% and the specificity was 88.9%. The sensitivity and specificity of ds-DNA antibody that detected by Crithidia luciliae based indirect immunofluorescence were 59.5% and 87.0%, correspondingly . With the decrease of ds-DNA antibody and ANuA titer, the positive rate of SLE was also decreased. Conclusions The sensitivity and specificity of ds-DNA antibody and ANuA in western blot,and Crithidia luciliae based indirect immunofluorescence for ds-DNA antibody were not satisfactory, not beneficial to early diagnosis and follow-up of SLE. Considering the factor of clinical economics , we proposed that ds-DNA antibody and ANuA with qualitative detection can be detected in case of need.